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Childs Health > Epilepsy > Flashcards

Epilepsy Flashcards

1
Q

What is epilepsy?

A

Umbrella term for condtion when there is a tendency to have seizures

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2
Q

What are seixures?

A

Abnormal electrical activity in brain

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3
Q

What is a generalised tonic-clonic seizures?

A

Loss of consciousness and tonic (muscle tensing) and clonic (muscle jerking) movements

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4
Q

What can be ass with a generalised tonic clonic seizure?

A

Tongue biting, incontinence, goraning, irregular breathing

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5
Q

What happens after a seizure?

A

Post ictal period

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6
Q

What happens in the post ictal period?

A

Confused, drowsy, feels irritable or low

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7
Q

Where do focal seizures start in the brain?

A

Temporal lobes

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8
Q

Tonic clonic vs focal seizure treat

A

Swap first and second line
1st - sodium valproate or levetriacetam
2nd - carbamazepine or lmaotrigine

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9
Q

How can focal seizures present?

A
  • Hallucinations
  • Memory flashbacks
  • Déjà vu
  • Doing strange things on autopilot
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10
Q

How long do absence seizures normally last?

A

10-20s

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11
Q

What can atonic seizures be indicative of?

A

Lennox-Gastaut syndrome

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12
Q

What is lennox-gastaut syndrome

A

‘epileptic and developmental encephalopathy’ because the epileptic seizures and the abnormal EEG are thought to be important in these childrens’ developmental delay and learning difficulties.
v severe
4 years

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13
Q

What is an atonic seizure?

A

Brief lapses in muscle tone

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14
Q

What do myoclonic seizures occur in children as a part of?

A

Juvenile myoclonic epilepsy

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15
Q

What is West syndrome?

A

Infantile spasms starting at around 6 months characterised by clusters of full body spasms

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16
Q

Prognosis of West syndrome

A

1/3 die by 25
1/3 seizure free

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17
Q

First line treatments for West syndomre

A

Preednisolone
Vigabatrin

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18
Q

What are febrile seizures caused by?

A

Fever

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19
Q

What age children do febrile seizures occur in?

A

6 months to 5 years

20
Q

Outcome of febrile convjulsions

A

Good
1/3 will have another
Slight increased chance of developing epilepsy

21
Q

Investigation for epilepsy

A

EEG - electroecnephalogram

22
Q

When to use an EEG to investigate epilepsy?

A

After the second simple-tonic clonic seizure

23
Q

When is an MRI considered for investigatiing seizures?

A

Child under 2 years when has first seizure
Focal seizures
No response to first line anti-epileptic medications

24
Q

What additional investigations except brain imaging can be used to rule out seizure causes?

A

ECG
Blood electrolytes - Na, K, Ca, Mg
Blood glucose - hypo/diabetes
Blood cultures, urine cultures and lumbar puncture - sepsis, encephalitis or meningitis

25
Q

What advise parents about with childs epilepsy?

A

Safety precautions
Recognising, managing and reporting seizures
Avoid situations where seizure may put child in danger

26
Q

Dangerous situations for children with seizures

A

sHOWERS NOT BATHS
Cautious swimming unless close supervision and seizures well controlled
Cautious with:
heights
Traffic
Heavy, hot or electrical equipment

27
Q

How do maintenance epileptic drugs work?

A

Raising seizure threshold and reducing liekelihood patient having a seizure

28
Q

How does sodium valproate work?

A

Increase activity of GABA, relaxing effect on brain

29
Q

Side effects of sodium valproate

A

Teratogenic
Liver damage and hepatitis
Hair loss
Tremor

30
Q

Side effects of carbamazepine

A

Agranylocytosis
Aplastic anaemia
Induces P450 system

31
Q

Phenytoin side effects

A

Folate and vitamin D deficinecy
Megoloblastic anaemia (folate deficiency)
Osteomalacia - vit D def

32
Q

Ethosuximide side effects

A

Night terrors
Rashes

33
Q

Lamotrigine side effects

A

Stevens-Johnson syndrome or DRESS synrome = life threatening skin rashes
Leukopenia

34
Q

Management of seizures

A
  • Put the patient in a safe position (e.g. on a carpeted floor)
  • Place in the recovery position if possible
  • Put something soft under their head to protect against head injury
  • Remove obstacles that could lead to injury
  • Make a note of the time at the start and end of the seizure
  • Call an ambulance if lasting more than 5 minutes or this is their first seizure
35
Q

What are epilepsy syndrome?

A

Typical age of onset
Specific seizure types and developmental antecedents/consequneces, physical exam
EEG and radiographic characteristics
Helps in pronosis but not a diagnosis

36
Q

What is childhood absence epilepsy?

A

3-4 onset
Similar EEG and physical appearances
Treat for around 2 years
Normally grwo out of it

37
Q

Epilepsy imitators

A

Syncope and anoxic seiaures
Behavioural psychological and psychiatric disorders

38
Q

Examples of cynxope and anoxic seizures

A

Vasovagal syncope
Breath

39
Q

Take history of seizure

A
39
Q

Take history of seizure

A
40
Q

What is febrile status epilepticus

A

Longer than 5 mins of seiuzreu

41
Q

How old are children who get febrile seizures?

A

6 months to 5 years

42
Q

Common infections causing febrile seizures

A

Viral infections
Tonsilitis
Otitis media
Gastroenteritis
Post immunisation

43
Q

Why is it important to investigate febrile seizures under one?

A

Difficult to differentiate between meningitis and viral cause in under one years old

44
Q

Serious causes of febrile illness in children

A

Meningitis
UTI
Chest infections

45
Q

What to do after febrile seizure

A

Watch on ward
Blood tests
Urine tests
CSF if strong sus meningitis

46
Q

When need to medicate febrile seziures

A

Staus epilepticus - over 5 mins

Childs Health (82 decks)

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